[Venous endoprosthesis. Palliative treatment of superior caval syndrome of neoplastic origin]. / Endoprothèse veineuse. Traitement palliatif du syndrome cave supérieur d'origine néoplasique.

Twenty-three patients with SVC syndrome were evaluated with CT and venography. The superior vena cava or its tributaries were either stenosed or thrombosed. The etiology was malignant in all cases: non small cell carcinoma (16 cases), mediastinal nodal metastasis (3 cases), lymphomas (2 cases), pleural mesothelioma (1 case), small cell carcinoma (1 case). The length of the stenosis ranged from 20 to 70 mm. The stents were placed via a femoral, jugular or brachial approach. Stenting was achieved in 22/23 patients (96%). Clinical symptoms subsided in 20/22 patients (87%). Mean follow-up was 15 weeks. Stents remained patent in 17/20 patients (78%). Stenting is a safe and effective treatment of SVC syndrome in patients with malignant conditions.

A new hepatitis C virus-like flavivirus in patients with cryptogenic liver disease associated with elevated GGT and alkaline phosphatase serum levels.

The intriguing co-infection of two flaviviruses (GBV-A and GBV-B) in tamarins and the recent discovery of another flavivirus (GBV-C/HGV) in humans raises the question of the relations between hepatitis C virus (HCV) and GBV-C/HGV. To address this issue the sera of 285 patients with liver disease (102 patients with cryptogenic and 183 with known forms of chronic liver disease) and 19 patients without liver disease were tested for HGV-RNA. GBV-C/HGV-RNA was detected by RT-PCR using primers encompassing 5'NC and NS5 regions and hybridization with specific biotinilated and radiolabelled probes. GBV-C/HGV RNA was found in 11 of 20 (55%) acute hepatitis C patients, in 13 of 117 (11.1%) patients with chronic hepatitis C, in 11 of 27 patients with a liver transplant (40.7%), one of 19 (5.3%) patients with chronic HBV infection, 15 out of 102 (14.7%) patients with cryptogenic liver disease and two out of 19 patients with inflammatory bowel disease. In cryptogenic patients, elevated serum gammaglutamyl transpeptidase (GGT, higher than twice the normal values) and alkaline phosphatase (ALP, above normal values) levels were significantly associated with GBV-C/HGV-RNA infection (P < 0.001). In conclusion GBV-C/HGV appears to be transmitted in humans by blood exposure and to be associated with liver disease in HCV co-infected patients and in a minority of patients with cryptogenic disease. The virus is only occasionally pathogenic for the liver and when liver damage is present; the association with the combined elevation of GGT and APH serum levels might represent a specific feature of the liver tropism of the agent.

[Thrombosis of the superior mesenteric artery and Behçet's syndrome]. / Thrombose de l'artère mésentérique supérieure et syndrome de Behçet.

The authors describe the third case in the literature of superior mesenteric artery's thrombosis occurring in the course of the Behçet's syndrome according to Mason and Barnes classification. Clinical manifestations in the patient were represented by intestinal angor. The literature data concerning vascular involvement in Behçet's disease, particularly thrombosis are reviewed. The value of noninvasive paraclinic arterial digestive explorations is discussed.

[Aortic aneurysms due to Yersinia enterocolitica: three new cases and a review of the literature]. / Anévrismes aortiques a Yersinia enterocolitica: trois nouveaux cas et revue de la littérature.

We report three cases of mycotic aortic aneurysms due to Yersinia enterocolitica. In all cases, serogroups are O:9. The three patients more than 70 year-old men with immunodeficiency underlying conditions allowing bacterial graft (neoplasia, diabetes mellitus, dysimmunitary syndrome, hematologic diseases). The six cases of the literature were clinically, biologically and epidemiologically similar. The strains of Y enterocolitica responsible for septicemia are especially serogroups O:9. This is probably due to particular virulence factors in this serogroup (phagocytosis resistance gene: yopH, ypkA et yop E) (yop: Yersinia outer membrane proteins). The presence of a pYV plasmid (plasmid yersinia virulence), found in Yersinia pathogen strains, lead to bacterial proliferation in the tissues. The authors discuss pathophysiological mechanisms involved in arterial bacterial graft following an Y. enterocolitica infection.